Volume 11 Issue 76
Published - 14:00 UTC 08:00 EST 21-Mar-2009 
Next Update - 14:00 UC 08:00 EST 22-Mar-2009

Editor: Susan K. Boyer, RN
© Vidyya.
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Survival benefit from brain cancer regimen persists over time

(21 March 2009: VIDYYA MEDICAL NEWS SERVICE) -- Patients with brain cancer who received a combination of temozolomide (Temodar) and radiotherapy lived longer than those who received radiotherapy alone, and evidence of a benefit was seen in some patients for up to 5 years, according to updated results from a large clinical trial published online March 9 in The Lancet Oncology. The researchers cautioned, however, that most patients who were successfully treated with the combination therapy eventually had a recurrence and died.

In 2004, European and Canadian researchers first reported a survival benefit for patients in the EORTC-NCIC trial who received the combination therapy compared with patients who received radiation alone. Though the improvement was modest (several months), it was the first treatment advance in decades for the deadly disease. Consequently the regimen of temozolomide plus radiation became a standard treatment for glioblastoma.

The newly updated results show that at 3 years, 16 percent of patients in the temozolomide group were alive compared with only 4 percent in the radiation-alone group. At 4 years, 12 percent were alive after treatment with temozolomide compared with 3 percent for radiation therapy alone, and at 5 years, 9.8 percent were alive versus 1.9 percent, respectively.

Improvements in survival were seen in patients from all prognostic subgroups, including older patients and those whose tumors could not be removed by surgery. Among patients with more favorable prognoses, 41 percent were alive at 2 years and 28 percent at 5 years. The strongest predictor for a bene?t from temozolomide was the inactivation of a gene called MGMT.

New treatments for the disease are needed, and several trials are investigating the addition of other treatments to temozolomide and radiotherapy, the researchers noted. “Until better treatments are available, radiotherapy with concomitant and adjuvant chemotherapy is the current standard of care,” they wrote.

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